review of Perfect Health Diet, second edition

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I guess like most real foodies, I vaguely knew about the "Perfect Health Diet" long before I got the book.

Paul and Shou-Ching Jaminet took the basic Paleo diet, added to it what they call "safe starches" (which for most people means rice and potatoes), and came up with their unfortunately-named diet.

I say it has an unfortunate name because the name itself kept me from reading this book for quite a long time. I'd think, "Sure, YOUR diet is perfect, as opposed to paleo or primal or WAPF or GAPS or AIP or Wahls' protocol or even my own diet recommendations" and the implied hubris in there bugged me.

But I think I was misreading that all this time, as the adjective "perfect" modifies "health" not "diet". My reading comprehension was way off.

Paul regularly posts on Facebook and blogs on their own site and it's quite obvious he is not full of himself, but conversely open to ideas and discussion and extremely approachable.

My mistaken aversion to the book was unfortunate for me; this is the book I'd have liked to write myself, if only I had a couple years to devote to such a project and a couple graduate students to work for me.

Not having those resources, I am grateful to the Jaminets for this book.

The diet is summarized by the apple infographic.

Perfect Health Diet infographic
"Perfect Health Diet infographic" from Perfect Health Diet

Personally, I find the infographic a bit confusing, but trying to summarize what we should eat for optimal health is just not something that lends itself to simplification.

However, the PHD diet and supplement recommendations (which includes things like egg yolk and liver as well as pills) are all available on their site. You can go there, read their stuff and do the diet right now, without ever buying the book.

Perfect Health Diet, second edition, Kindle version

You don't buy this book because you want someone to tell you what to eat. You buy it because you are a big old real foodie nerd.

We speak of "nutrient-dense" food all the time in a hand-waving kind of way. We have vague ideas about what that means, that it means eschewing vegetable oils for animal fats, that it means eating in a manner that gets vitamin A & D, that it means eating vegetables and fruit instead of packaged foods, that we should eat organ meats and drink bone broth.

There is nothing hand-waving about the PHD recommendations. For every macronutrient and micronutrient, they do the research, resulting in recommendations about the minimum and maximum doses required for ideal health, and then covering which foods in what amounts provide that.

Macros covered include protein, carbohydrate, fat (PUFA vs. monos vs. saturated vs. small and medium-chain), fiber and alcohol. Micros covered include vitamins A, D, and K2, selenium and iodine, potassium and sodium, calcium, collagen, and magnesium, zinc and copper, vitamin C, choline and folic acid, and other (B vitamins, vitamin E, chromium, manganese, iron, molybdenum, boron, nickel, silicon, vanadium, lithium and taurine).

There are hundreds of references justifying their recommendations for minimum and maximum intake of each nutrient and corresponding food calculations, showing for example that a quarter pound of beef liver each week provides the proper dose of copper and 7 oysters provide the balancing zinc.

Some of you got wet reading the previous few paragraphs; you should click on the Amazon ad to the right and just buy the book now. ;) (That's the Kindle version, which is what I have, as I prefer to be able to search books, but it's also available in both dead-tree and audio versions.)

other topics covered

ancestral diets

There's a large section of the book in which they discuss ancestral diets (which seems to be paleo and all offshoots like primal and phd itself), the composition of breast milk vis a vis infant vs. adult nutritional needs, the diets of many mammals, with huge numbers of references (as the entire book is full of).

what not to eat

They classify four major toxins, grains, vegetable oils, sugar and legumes.

Obviously, grains exclude rice, which they like.

Vegetable oils and sugar are no-brainers, but again, piles of discussion and references are provided if you need convincing.

I disagree with legumes, which I discuss below. I see no reason for cassava, which must be prepared by ssoaking, sprouting or souring to render the cyanogenic glucosides safe, to be a "safe starch" and legumes, which require similar preparation to be "toxic". But read their arguments and make up your own mind!

chronic infections, immunity, intermittent fasting, blood lipids, circadian rhythm, weight loss, meal plans

Again, lots of discussion, lots of references - very interesting stuff.

I found the meal plans and recipes the weakest bit of the book.

stuff I disagree about

pork

They believe pork has too high an omega-6 content. Ironically, when they get to looking at Polynesian diets at the end of the book, the example diets they choose as ideal contain lots of pork!

How good or bad pork is depends on how it's raised. CAFO pork is pretty much crap, I agree.

Ideally, pork should be raised outdoors, on pasture, so as to increase the vitamins A, D3 and K2 content of the fat and improve the fatty acid composition.

Of course, unless your pasture is under an orchard, there's not going to be enough food for pigs on pasture. Pigs are not cows, their digestive tracts are very similar to ours, they are not intended to live on grass; you have to feed them something.

IMO, in an ideal world, pigs would be raised by dairies and fed all the leftover skim milk and whey as dairy is processed into yummy high-fat products.

But I honestly settle for pork raised on organic feed, with a slight preference for soy-free feed. As long as they are outside, running around in the real world and not fed total crap, that's good enough for me.

I have previously written about buying and processing half hams, which is how I stretch expensive pastured into a lot of meals. It's an indispensable part of my cooking strategy. Though most of those meals are less than a half pound of ham, so I guess I am limiting pork in doing so as they suggest, except they disapprove of processed pork entirely.

But my biggest argument against their anti-pork stance is: bacon!

pastured meat and dairy

There is absolutely no discussion in the book whatsoever of the benefits of choosing pastured meat and dairy over CAFO stuff. For lean meat, it probably doesn't matter much. But for fatty meat and diry products, I believe it is absolutely critical for two reasons.

First, all chemicals are either water-soluble or fat-soluble. Water-soluble toxins in a CAFO operation will primarily be excreted in the animal's urine and thus not be a big deal. But fat-soluble toxins collect in an animal's fat and become concentrated. Thus products like fatty meats, full-fat milk, yogurt and cheese, and butter are relatively poisonous when the animals are badly raised.

The other half of the equation is that the nutrients we eat these foods for just aren't there in CAFO products. Animals produce vitamin A via the actions of their gut biome interacting with carotenes in grass. They produce vitamin D the same way we do, by being out in the sunshine. I'm not entirely sure how they produce vitmain K2, suspect it's also a gut-related phenomenon, but it's definitly been shown there's more K2 in the fat of pastured animals.

I personally think pastured meats and dairy are the most important foods to buy high-quality, both to reduce toxins and increase nutrition - way more important than organic vegetables.

But we live in the real world and everyone can't afford to do that, I get that. I recommend if you must buy CAFO meat and dairy, that you buy the lowest fat stuff you can to minimize the toxins. And of the pastured products you can afford, buy the highest fat products to maximize nutrition.

I also tend to think butter, being nearly entirely fat, is the most important product to buy pastured if at all possible. I'd give up all pastured products and organics to save my butter if the budget required.

legumes

They're a bit inconsistent in their recommendations classifying legumes as one of the four major toxins. They admit beans can be OK if properly prepared. But they claim cassava as one of the "safe starches".

Legumes, if not properly prepared, contain phytates and lectins, both classified as antinutrients, likely to cause leaky gut. Cassava, if not properly prepared, contains cyanide compounds to cause poisoning, goiters and paralysis. Seems to me I'd be more willing to risk the beans...

Obviously, the proper preparation is key. Most people are not growing cassava in their backyard gardens, but purchasing either pearled tapioca or tapioca flour in a grocery, where it has already been properly prepared to not poison them. Whereas most people would have to prepared beans or peas themselves.

I am seriously disabled and work hard to find shortcuts in the kitchen. But properly preparing legumes is ridiculously easy, so much so that even crippled old me can handle it. There's two basic steps.

Step one is just soaking in an acidifed medium. I do this a day or two before I'm planning a bean or pea meal. It takes all of a minute! I measure some beans or peas in a bowl. I add a "glug" of vinegar. For each cup of beans, I add a quart of water. Cover with a plate and let sit there for a day or two. I complete this process while I'm doing dishes in the evening; it takes no real time in the kitchen. This greatly reduces the phytic acid in legumes, so I do it even when it's not necessary for cooking, like with split peas.

The second half is to pressure cook your beans, which destroys the lectins. This step of preparation is actually easier than regular cooking on the stovetop in a pot! I use a Presto pressure cooker and it takes 15 minutes to cook beans to the just softened but whole stage or 40 minutes to cook them to mush like for soupy or refried beans. You put in beans, liquid (I use bone broth), cover, bring to a hard boil, put on the weight, reduce heat to where the jiggler is just jiggling, cook for the time needed, then stick in the sink and run cool water until the pressure is released. Most of the time, I am doing the entire recipe in the pressure cooker, not just cooking the beans, so it's ridiculously easy.

The thing about adding properly-prepared legumes to the diet is it is a great budget-stretcher. We could not afford as much pastured meat and dairy nor as many organic vegetables if we didn't do a lot of beans. I do a big bean or pea dish every week, as well as a big egg dish, which also stretches the budget.

NOTE: It has come to my attention that Paul has reversed himself on properly-prepared legumes, at least with regards to lentils and chickpeas; I'm uncertain if that includes all dried beans and peas or not. So disregard at least some of my disagreement!

corn

It is one thing to say that potatoes and sweet potatoes are paleo, but once you've added rice, you're not looking at paleo anymore, just at which grains are safest.

I completly agree that white rice, since the bran with the phytates are removed, is as "safe" as grains get. And there are certainly very large populations that depend on rice as a staple.

But I do not understand why corn is excluded. Corn has also had very large populations that depended on it as a staple.

And corn is the only grain that is feasible to grow as a staple in your backyard as being a large grain, it can be harvested, shucked and threshed by hand and small batches can be ground either by hand or in a small electric grinder.

For those of us with a homesteading bent, corn is the perfect grain crop. Note that I am not talking about the crappy GMO corn crops, nor even the previous generation of dent corn crops, but real flint and flour corns as were eaten by many generations of Native Americans.

Whole grain corn does contain both phytase and zein (a lectin). I believe nixtmalization must reduce both, as explained in my corn article. But I don't think the phytins or lectin content is significant and there are ways to minimize it.

summary

I may have spent too much time in this review expressing my disagreement, but that's cause I'm an argumentative sort.

This book is seriously the wet dream of any foodie nerd. The discussion, the references, the braininess applied to food - it's just awesome stuff.

If you are someone who ever considered wearing both an apron and a labcoat, you will love this book.

Disclosure: Review